Letter to the Editor

Life-Threatening Ventricular Arrhythmia Induced by Hypokalemia During Sodium Bicarbonate Infusion

Authors: Cheng-Jui Lin, Yi-Chou Chen, Han-Hsiang Chen, Chun-Chieh Liu, Chih-Jen Wu

Abstract

To the Editor:


Sodium bicarbonate is commonly used for short-term relief of severe metabolic acidosis or testing for renal tubular acidosis. However, rapid serum alkalization can result in a variety of complications, including fluid overload, cardiac arrhythmia, seizure, hypokalemia, and hypocalcemia. Hypokalemia results from promoting potassium movement into cells by an infusion of sodium bicarbonate.1,2 We report a case of ventricular tachycardia induced by hypokalemia during sodium bicarbonate infusion.

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References

1. Gennari FJ. Hypokalemia. N Engl J Med 1998;339:451–458.
 
2. Adrogué HJ, Madias NE. Changes in plasma potassium concentration during acute acid-base disturbances. Am J Med 1981;71:456–467.
 
3. Micha Maeder, Hans Rickli, Christian Sticherling, et al. Hypokalaemia and sudden cardiac death—lessons from implantable cardioverter defibrillators Emerg Med J 2007;24:206–208.
 
4. Macdonald JE, Struthers AD. What is the optimal serum potassium level in cardiovascular patients? J Am Coll Cardiol 2004;43:155–161.